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1.
J Foot Ankle Surg ; 58(4): 657-662, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31010766

RESUMO

Hammertoe deformation is a frequent motive for consultation in forefoot surgery, and proximal interphalangeal joint arthrodesis is a classic treatment for fixed deformation, which tends to be achieved more and more thanks to specific implants. This work evaluated and compared clinical improvement, radiologic fusion, and complication rates between dynamic (Difuse®) and static (TinyFix®) implants from Biotech Ortho. A total of 95 patients (110 feet and 166 toes; 97 static and 69 dynamic implants) were included. Mean age was 63.6 (±12.6) years in the dynamic group and 62.3 (±14.01) years in the static group. Epidemiologic and intraoperative radiologic data were collected. Pain, toes deformity, complications, and radiologic findings (bone fusion and osteolysis) were recorded at 4 months postoperatively and at the last follow-up. Mean follow-up was 11.5 (range 4 to 28) months, and the position of the implants was more often satisfying in the dynamic group (p = .01). Fusion rates at 4 months were 67% and 80% in the dynamic and static groups, respectively (p = .05). Radiologic osteolysis occurred more frequently in the dynamic group (p = .05 at 4 months), and pain was still present in 3% in the dynamic group at the last follow-up compared with 7% in the static group. Complication rate was 7% in the dynamic group (implant fractures) and 4% in the static group. Revision was considered more often in the dynamic group (p = .01). The static titanium implant seems superior to the dynamic memory shape implant in Nitinol alloy with regard to fusion (p = .04), complications (p = .03), and revision rates (p = .01). The literature review seems to support the good results of static implants compared with the rest of the available arthrodesis implant solutions.


Assuntos
Artrodese , Síndrome do Dedo do Pé em Martelo/cirurgia , Prótese Articular , Articulação do Dedo do Pé/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ligas , Artrodese/efeitos adversos , Artrodese/métodos , Fios Ortopédicos , Feminino , Seguimentos , Síndrome do Dedo do Pé em Martelo/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteólise/diagnóstico por imagem , Osteólise/etiologia , Complicações Pós-Operatórias , Desenho de Prótese , Radiografia , Estudos Retrospectivos , Articulação do Dedo do Pé/diagnóstico por imagem , Resultado do Tratamento
2.
SICOT J ; 3: 3, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28074775

RESUMO

INTRODUCTION: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. METHODS: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit. RESULTS: The first reduction attempts were unsuccessful and during the new attempt, we observed a hematoma. A CT scan showed a disruption of the axillary artery and a bilateral pulmonary embolism. CONCLUSION: Neurovascular injury must be systematically sought before and after reduction, and a multidisciplinary approach is always necessary.

3.
J Wrist Surg ; 2(3): 234-8, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24436822

RESUMO

Background Posttraumatic arthritides of the radiocarpal joint, secondary to scaphoid nonunion advanced collapse (SNAC), scapholunate advanced collapse (SLAC), or Kienböck disease or in cases of intraarticularmalunion of the distal radius, are classically solved by some type of arthrodesis procedure. Osteochondral grafting provides a possible motion-sparing option that can diminish pain in the active patient. Description of Technique A chondrocostal graft harvested from the ninth rib was inserted and fixed with a plate in place of the articular defect in cases of a malunited intra-articular distal radius fracture (7 cases) or to replace the proximal pole of the scaphoid in cases of SNAC or SLAC (18 cases). In Kienböck disease, the graft was inserted as a free cartilage spacer (4 cases). Results Harvesting the graft from the ninth rib had minimal morbidity without pleural injury in the reported series. Graft union was achieved in all cases of fixation. No graft resorption or necrosis were observed on X-ray and magnetic resonance imaging (MRI) evaluation at the longest follow-up of 10 years. Histological analysis performed at the time of plate removal showed the vitality of the graft. Two thirds of the patients had excellent or good results using the Green and O'Brien score. Conclusions Reconstruction of a partially destroyed articular surface using a costal graft is reliable and provides an alternative option for resurfacing the articular surface with viable cartilage.

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